Facial blushing treated by sympathetic denervation – longlasting benefits in 831 patients

Abstract

As this is an open study and 37% of patients did not respond to the questionnaire, the results must be viewed with caution. ETS, however, appears to be an effective, safe and lasting surgical method for the treatment of severe facial blushing. Side-effects, especially compensatory sweating on the trunk and legs are common, and may be severe but only rarely result in the patient regretting the operation.

Synergistic application of cardiac sympathetic decentralization and comprehensive psychiatric treatment in the management of anxiety and electrical storm

“…This was due to the selectivity of the patient's lesion, which spared the caudal head of the stellate ganglion, a region carrying sympathetic nerve fibers to the eye and face. The patient did report the subsequent absence of sweating of the palms and head, and development of hyperhidrosis of the trunk and legs, which have been described as compensatory responses to the severing of sympathetic nerve fibers to the trunk (Hashmonai et al, 2000; Drott et al, 2002). …”

“…This data yields a preliminary hypothesis that the BCSD procedure itself may have a positive impact on mood and anxiety in these patients beyond simply decreasing arrhythmias, ICD shock frequency or reducing autonomic responses to mental and physical stressors. Indeed, partial sympathectomy has been applied as a treatment for several decades in medical disorders with high mortality rates (Schwartz et al, 1991), low mortality rates (Hashmonai et al, 2000), as well as for affective disturbances (Drott et al, 2002) (but see Crozier (2003) for a discussion of the downsides of this latter approach). Such invasive approaches should never be undertaken lightly, and should only be considered after careful examination of the potential risks and extensive discussion with a patient who possesses decision-making capacity.…”

In praise of blushing

“…There is little doubt that the experience of blushing causes distress to many people, in some cases to the extent that they are prepared to undergo surgery to prevent their facial reddening 1 . It seems too, although this is an issue that is in need of empiric research, that many sufferers regard blushing as the cause of their difficulties that, they believe, would disappear if they did not redden.…”

Blushing unseen

“…Why, for example, do social phobics who complain of blushing go no redder, as judged by ‘facial blood volume changes’, than those who do not? 7 But there can be no doubt that social phobia is a serious problem, affecting at least 5% of the population. Often it does not do well with psychological or pharmacological treatments, and a successful surgical approach 8 (see Drott C et al . and subsequent correspondence in this issue on page 219–220) is therefore to be welcomed.…”